<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_type')}:</label>
        <div class="col-xs-12 col-sm-8">       
            <select  id="c-order_type" class="form-control selectpicker" name="row[order_type]">
                {foreach name="orderTypeList" item="vo"}
                    <option value="{$key}" {in name="key" value="10"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>
    
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">医生:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/doctor/index" data-field="nickname" data-format-item="{nickname}（{mobile}）" data-params='{"custom[role]":"30"}' class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">项目:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_goods_id" data-multiple="true"  data-rule="required" data-source="goods/goods/index" data-field="title" class="form-control selectpage" name="row[order_goods_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group hide">
        <label class="control-label col-xs-12 col-sm-2">套餐:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-goods_package_id" data-multiple="true" data-rule="required" data-source="goods/goods_package/index" data-field="title" class="form-control selectpage" name="row[goods_package_id]" type="text" value="">
        </div>
    </div>
    <div id="rongqiview">

    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Username')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-username" class="form-control" data-rule="required" name="row[username]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Userphone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-userphone" class="form-control" name="row[userphone]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Age')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-age" class="form-control" data-rule="required" name="row[age]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gender')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gender" class="form-control" data-rule="required" name="row[gender]" type="text">
        </div>
    </div>
    
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
